Advance letter

0920-0222 Attach 3 Advance Letter Physician Opioid.docx

Collaborating Center for Questionnaire Design and Evaluation Research

Advance letter

OMB: 0920-0222

Document [docx]
Download: docx | pdf

Attachment 3: Advance Letter


D EPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service

Centers for Disease Control and Prevention

Shape1 National Center for Health Statistics

3311 Toledo Road

Hyattsville, Maryland 20782


Shape2

What do I do next?



If you want to schedule an interview or ask questions about this survey research, please call [FILL] at 301-458-[FILL].


The Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS) will be conducting preliminary survey research on knowledge and awareness of opioid prescription use for pain management.


The survey is best completed by physicians with knowledge of opioid guidelines and experience in prescribing opioid medication for pain management. Someone from the National Center for Health Statistics’ Center for Questionnaire Design and Evaluation Research will call to ask if you are willing to participate in a research interview.


If you are willing to help us, here is what you need to know:


  • In-person interview

  • Conducted at your convenience

  • No longer than one-hour

  • $100 as a token of our appreciation

  • Call 301-458-[FILL] to schedule an appointment


Participation is, of course, voluntary, and you may refuse to answer any question or may stop participating at any time without penalty or loss of benefits. All of the information you provide will be kept confidential.1


If you have any questions about your rights as a respondent in this research study, please call the Research Ethics Review Board at the National Center for Health Statistics toll-free at 1-800-223-8118. Please leave a brief message with your name and phone number. Say that you are calling about Protocol [fill]. Your call will be returned as soon as possible.


We greatly appreciate your interest and your help, and do look forward to working with you on this important topic.


Sincerely,







Jennifer Madans, Ph.D.

Acting Director

National Center for Health Statistics

1 This study is authorized by Section 306 of the Public Health Service Act (Title 42, U.S. Code 242k). All information collected as part of this study will be used for statistical purposes only and held in the strictest confidence according to Section 308(d) of the Public Health Service Act (42, U.S. Code 242m(d)) and the Confidential Information Protection and Statistical Efficiency Act (Title 5 of PL 107-347).

Page 1 of 2



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorMassey, Meredith (CDC/DDPHSS/NCHS/DRM)
File Modified0000-00-00
File Created2021-01-16

© 2024 OMB.report | Privacy Policy